The Blue Folder

The team at Doctors Grand Plaza have had great success with their version of the patient held health summary – “the blue folder”

Melissa Cahill tells their story.

"Our finest achievement conceived through the collaborative process is our “blue folder”. The blue folder is our version of the hand held record and the patients are encouraged to take it with them to specialist appointments, allied health appointments or to the Emergency Department if they need to present there.

In this is a copy of:

  • the patient’s medical history
  • current medication
  • allergies
  • immunisations
  • management plan
  • recent results (bloods, x-rays, echos etc) and
  • current ECGs or ABIs.

The management plan also includes our invention – the 'care calendar' (something I know that Tony’s practice has stolen shamelessly). The care calendar is a one paged three columned monthly calendar that sets out what needs to be done by the patient and the doctor for each month. The three columns include last year, this year and the next year. That way I can see what has been done when (i.e. the patients last yearly eye check was in Aug 2008 so it must be due again in Aug 09). and what is due to come before they are seen in 3 months time (i.e. we are seeing the patient in October and their ophthalmology appointment is due in November so a referral should be done at the October visit) and what is due in the future (i.e. their follow up colonoscopy or pap smear is not due til next year).

If updated correctly and regularly (I try to update the calendar even when I get a specialist letter telling me the patient is due to see them in 6 months), it is an easy way to know what is due when (without going through screens of old notes and blood results) and helps keep the patient organised as well (I derive great pleasure when the patient tells me when their blood tests are due rather than the other way around).

We continually get great feedback via the patients from the hospitals about our folder. One of my regular patients came in to see me today. We had tried very hard to sell him the idea of the blue folder but he finally took it in with him when he saw a physician at the PAH. He told me with great pride that the physician and the registrar poured over the folder with its depth of information like “piranhas” and that the comments they gave were "impressive” and “every doctor should look after their patients like this”.

Needless to say that made me quite proud and ensured that he would continue to take his blue folder to all his specialist appointments in future".

Melissa has been kind enough to share an example of their care calendar.

Are you using a patient held record? Have you found it useful? What do you include? Have you any sample pages to share?

 Doctors Grand Plaza, QLD.

Comments

Hi Melissa

Its a very good idea I think -but how many times do patients carry it with them?
And once patients make it a point to carry it with them then perfect solution to many problems.

Good start ? impressed!

Jagdish

Posted by .(JavaScript must be enabled to view this email address)  on  06/30  at  11:06 AM

Good idea and quite easy to do ? The big advantage with the folder is that the patient has ownership rather than being out of the loop. Most of the time we send the letter electronically to the specialist and it includes bloods etc. I haven?t tried including ECG using data tool bar but it can probably also be included in the electronic letter. Do you find it is a nuisance to have to update the blus folder as well as doing everything else in a consultation?

Posted by .(JavaScript must be enabled to view this email address)  on  06/30  at  11:07 AM

Great idea Melissa but its still a pity in 2010 that individual organisations have to implement time consuming strategies to improve the coordination of care between the acute care and primary health care sectors (I?m presuming your patient information system doesn?t have the capability to ?drag? all the items into a patient summary and care plan to put in the blue book for the client?)

What a shame the National E Health Strategy has not been implemented like the NT Shared Electronic Health Repository (which is inclusive of all in the blue book except ECG?s). Viewing of client records via the SEHR is standardised (without having to interpret 100 different organisation?s paper work). Of course the client can always hold a copy if requested.

Will we ever see a National E Health Strategy and standardised patient information recall systems???

Posted by .(JavaScript must be enabled to view this email address)  on  06/30  at  11:09 AM

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